Physiotherapeutic scoliosis-specific exercises (PSSEs) are an increasingly popular non-surgical method for treating scoliosis. PSSEs - so named to differentiate them from non-specific physiotherapy programmes - aim to provide a more functional approach to scoliosis management and improve the patient's quality of life.

Scoliosis PSSE Treatment

The Schroth method

The Schroth method is a particularly well-known type of non-surgical scoliosis treatment. Devised by a German woman named Katharina Schroth, it uses tailored exercises for each individual to help their curved spine return to a straighter, more natural position.

Schroth realised that 3D postural correction could only be achieved through a series of corrective exercises designed to support a corrected posture and alter the postural perception of the individual suffering from scoliosis. Focusing on a number of objectives - including de-rotating, elongating and stabilising the spine on a three-dimensional plane - Schroth exercises focus on restoring muscular symmetry and alignment of posture whilst teaching patients to be more aware of their posture on a day-to-day basis.

Learn more about the Schroth method >>

 

Physiotherapeutic scoliosis-specific exercises

Scoliosis is, of course, a very complex condition. From the rear, it looks like a sideways curve in either a 'C' or an 'S' shape. However, what you can't see are the ways in which the vertebrae in the spine rotate as that curve develops. Spaces between the vertebrae may also become stretched in some areas and compressed in others. For this reason, scoliosis-specific physiotherapy requires a 3D approach to address the curve from all angles and directions.

The extent of the rotation in the spine differs widely from one case to the next; therefore, when treating scoliosis with PSSEs, the exercises need to be tailored to the unique condition of the patient's spine. Exercises can be performed whilst sitting, laying down or standing up, with several props being used to assist such as gym balls and wall bars. Take a look at our video below to see some simple versions of these exercises in action!

These exercises help to promote:

  • Muscular symmetry - The muscles in your back are affected by changes in the curvature of your spine. One side may see muscles weaken, whereas on the other side muscles may be overworked. Therapeutic exercises should seek to address both problems and achieve symmetry between the two sides.
  • Rotational breathing - The Schroth method utilises a unique breathing technique known as 'rotational breathing', where the idea is to use breathing to assist in the de-rotation of the spine, thereby reshaping the rib cage and the surrounding soft tissue.
  • Postural awareness - Being aware of the position of your spine is the first step towards correcting it. Postural awareness is particularly important when it comes to performing day-to-day activities.

 

Treating scoliosis with PSSEs

The Schroth method forms the foundation of the scoliosis treatment courses we provide here at the Scoliosis SOS Clinic. However, we understand that there are elements of postural correction that Schroth is unable to address on its own. Therefore, all of our treatment plans are enhanced and complemented by an assortment of other well-established physiotherapeutic techniques from all around the world, ensuring that all aspects of each patient's condition can be addressed effectively.

The result is our internationally-renowned ScolioGold treatment method. Use the links below to view before/after photos or book your initial consultation with Scoliosis SOS.

Photos: Before & After Treatment >   Book an Initial Consultation >

The history of scoliosis therapy can be traced all the way back to ancient Greece.

More specifically, scoliosis treatment has its roots in the 5th century BC and one man in particular: Greek physician Hippocrates (c. 460 – 370 BC).

Statue of Hippocrates

Who was Hippocrates?

The mid-to-late 5th century BC was a turbulent time for the Hellenic people.

From 431 to 404 BC, the country was entrenched in a titanic war between the Delian League of Athens and the Peloponnesian League of Sparta. Meanwhile, Athens was also suffering from a devastating plague, which wreaked havoc in the city periodically between 430 and 426 BC.

In short, it was a dark time for Greece. But this was also the period that gave us Hippocrates, often referred to as the 'father of medicine'.

Born on the island of Kos around 460 BC, Hippocrates was the son of a physician and is believed to have learned the trade from his father. Among his long list of medical achievements, Hippocrates is heralded as the first person to theorise that diseases and ailments were caused by environmental factors and not the result of superstition or an act of the gods.

He's also the namesake of the 'Hippocratic Oath': the pledge taken by doctors declaring their moral and ethical obligations to their patients as medical practitioners.

Hippocrates and Scoliosis

Separating medicine from religion would probably have been enough on its own to secure Hippocrates's place in history, but his achievements go far beyond that. Notably, he was also a key figure in the history of spinal treatment, and he is believed to have been the first physician to focus on the anatomy and pathology of the human spine.

Through his revolutionary study of the spinal structure and vertebrae, Hippocrates's work led to the pioneering identification of many spine-related diseases – including scoliosis.

Hippocrates is commonly credited as the person who coined the term 'scoliosis' and the first to try treating this condition.

Scoliosis

Hippocratic Scoliosis Treatment

From his unprecedented study of orthopaedics, Hippocrates created three pieces of equipment to treat spinal ailments: namely the Hippocratic ladder, the Hippocratic board, and the Hippocratic bench.

Hippocratic Ladder

Intended to reduce spinal curvatures, the Hippocratic ladder treatment required the patient to be elevated and tied to the ladder upright or head down (depending on the where the curvature lay). The patient would then be shaken on the ladder, with the gravitational pull theoretically straightening the spine.

Hippocratic Board

Similar to the ladder, treatment via the Hippocratic board involved the patient being tied to the board; however, this time, the patient was required to be prone, lying face down and flat. The physician would then apply pressure to the affected area of the spine using a hand, foot, or even the entire weight of the body.

Hippocratic Bench

Also known as the Hippocratic scamnum, the bench technique saw the patient lie face down on a bench similar to the board technique above. A smaller wooden board was then inserted into a pre-made hole in the wall, leaving the plank protruding out above the patient's back. An assistant would then apply pressure on the end of the plank while the physician manoeuvred the board along the body.

Like many ancient treatments, these techniques naturally seem archaic, even barbaric by today's standards. Nevertheless, these apparatuses – based on the principles of axial traction and three-point correction – were hugely innovative at the time, and they had a profound influence on the direction of spinal treatment to follow.

Luckily, medical science has come a long way since the days of Hippocrates, and there are now a variety of comfortable and safe non-surgical scoliosis treatments available. At Scoliosis SOS, our team of friendly, skilled therapists offer patients specialised scoliosis treatment that's specifically designed to enhance your quality of life.

Our Treatment Method   Contact Scoliosis SOS

Teenager Scoliosis X-Ray

For many teenagers with scoliosis, treatment options are limited and uniformly unappealing. Bracing, for instance, may help to control the condition, but scoliosis braces can be uncomfortable and they don't actually reverse the spine's curvature (they're designed to prevent it from getting worse).

And then there's spinal fusion surgery, which tends to be the recommended treatment for severe cases of scoliosis. Surgery can be an incredibly daunting prospect, especially for a teenager, so it's no wonder so many young scoliosis patients come to the Scoliosis SOS Clinic in search of an alternative treatment option.

Case Study: Molly, 16 Years Old

Molly came to our clinic because, like a lot of teenagers with scoliosis, she wanted to avoid having to undergo surgery except as a last resort. Molly was diagnosed with scoliosis when she was 15 years old, and she came across Scoliosis SOS while looking online for alternative treatment methods (since her curved spine was causing her pain and she didn't like the way it made her look).

Our ScolioGold treatment programme proved to be the ideal solution for Molly because it gave her the tools to improve her own condition through a set of carefully-chosen corrective exercises. The ScolioGold method combines a variety of non-invasive techniques that gradually restore the back's muscle balance and reverse the curvature of the spine. Learning and practising these exercises in a controlled environment with our expert physiotherapists gives teenage patients the knowledge and skills they need to continue improving their condition long after they have left our clinic.

If you want to hear more about Molly's scoliosis experience, you can watch our interview with her here:

Would you like to find out more about our scoliosis treatment courses? Get in touch with Scoliosis SOS today to arrange an initial consultation.

Schroth Method Treatment for Scoliosis

Here at the Scoliosis SOS Clinic, we've been successfully treating scoliosis patients for well over a decade. Our comprehensive ScolioGold treatment programme combines a variety of well-known therapeutic techniques, and the exercises that we teach our patients allow them to manage their symptoms and prevent progression from the comfort of their own home.

One of the techniques we use to treat our patients is the Schroth method, in which our therapists our expertly trained.

 

What is the Schroth method?

The Schroth method is an exercise-based physiotherapy programme that is used to treat scoliosis without surgical intervention. This world-renowned treatment method has helped countless people to improve their posture and overcome the symptoms of scoliosis.

The Schroth method is named after Katharina Schroth, the German physiotherapist who devised it. Schroth herself had a curved spine, and after making great progress with her own condition, she decided to open up a clinic to treat other people with scoliosis.

Katharina Schroth passed away in 1985, but her daughter Christa Lehnert-Schroth continued her work and the Schroth method is now used to treat scoliosis patients all over the world.

 

How does the Schroth method help people with scoliosis?

The Schroth method uses stretches and exercises to develop the inner muscles of the rib cage in order to correct spinal abnormalities in all three planes of the body. This treatment method also places emphasis on the conscious correction of posture during day-to-day life.

Schroth Method Exercises

The Schroth-based exercises that we use here at the Scoliosis SOS Clinic are customised to each patient's unique spinal curvature, as well as their age and physical ability. Our use of the Schroth method has allowed 88% of our patients to avoid the need for spinal fusion surgery. We also:

  • Use a specific rotational breathing technique to correct spinal rotation and increase the patient's lung capacity

  • Rebalance the patient's spinal position using pelvic corrections and isometric contractions

  • Make patients more aware of their posture on a daily basis, ensuring they have the correct equipment at home and at school/work to maintain their corrected position

Book a Consultation >

 

Examples of Schroth method exercises

Here are just a few of the stretches and exercises that make up the Schroth method:

1. Prone on stool

One of the core Schroth exercises, performed in a prone position facing towards the floor. Depending on the patient's classification, condition, previous medical history and symptoms, this exercise has the potential to correct:

  • A thoracic curve using shoulder traction, shoulder counter-traction and the de-rotation breathing technique
  • A lumbar curve via activation of the iliopsoas muscle

With a different setup, it can also be used to help thoracolumbar curves.

Prone on Stool Exercise

This exercise requires quite a few pieces of equipment including tubes, stools, belts, straps, beanbags and wedges. Watch our patient Isobel perform this exercise during a check-up appointment at the Scoliosis SOS Clinic:

 

2. Semi-hanging

This primary Schroth exercise uses gravity to stretch out the spine and relieve pressure on vertebral joints. At the same time, the patient will be applying the rotational breathing technique to flatten the prominent areas of their back, activating their muscles on exhalation to train their body to remember the corrected position when they stop exercising.

Semi-Hanging Schroth Exercise

This is often used as a preparation exercise at the beginning of a treatment session. A set of wall bars (or equivalent) is necessary to perform this exercise effectively.

Watch our patient Nicole, who travelled from Ghana to the UK for scoliosis treatment, practise this exercise with her therapist:

 

3. Iliopsoas on a ball

This is a very patient-specific Schroth exercise that is only suitable for someone with a lumbar or thoracolumbar curve. It works by utilising the activation of the iliopsoas muscle to help de-rotate the affected portion of the patient's spine. This is one of the simpler Schroth method exercises, requiring only a gym ball and wall bars (or equivalent).

Iliopsoas Ball Exercise

Here at the clinic, patients often receive assistance from the therapists using myofascial release techniques to 'mobilise' the spine and help the patient to achieve a straight posture in standing.

Watch our patient Molly from Suffolk perform this exercise:

The Schroth component of our ScolioGold therapy course places huge emphasis on conscious correction of posture throughout daily life, not just during exercise therapy. Education is paramount - throughout your 4-week course, our therapists will help you to learn about scoliosis and your body to ensure that you can recognise an abnormal posture and correct it accordingly.

More Scoliosis Exercises >

 

What is the Rigo-Schroth method?

The Rigo-Schroth method is a modification of the Schroth method. Devised in the 1980s by a Spanish practitioner named Dr Manuel Rigo, it is based on much the same regime of stretches as the Schroth method itself; however, the Rigo-Schroth method is structured differently, with significantly more emphasis on the role of the therapist.

 

Combining Schroth method exercises with other treatment techniques

Back when we first opened our clinic, our treatment courses were entirely based on the Schroth method, but over the years, we noticed that some aspects of scoliosis were not addressed through use of the Schroth method alone. So, to ensure that all aspects of each patient's condition are fully treated, we've combined the Schroth and Rigo-Schroth methods with a number of other exercise-based / non-surgical treatment to help provide our patients with a fully comprehensive treatment package.

Our Treatment Methods >

This approach has yielded superb results: our treatment courses have proved capable of preventing progression, improving posture and cosmetic appearance, reducing pain, improving quality of life, and reducing the patient's Cobb angle by up to 20 degrees.

To enrol on one of our Schroth-based scoliosis treatment courses, contact us online or give us a call on 0207 488 4428.

 

Further reading

When treating a child or teen with a curvature of the spine, doctors will often recommend bracing as a way of halting the curve's progression.

Back braces come in a variety of forms, each designed to prevent/minimise curvature development while the patient grows. Here, we look at two of the most well-known brace types: the Milwaukee brace and the Boston brace.

Milwaukee brace for scoliosis

Milwaukee brace

The Milwaukee brace may be prescribed to individuals who possess high thoracic (upper back) curves. It has an unusual design that is intended to manipulate the patient's full upper body: the brace extends from the pelvis all the way up to the neck, and it's manufactured with a contoured plastic pelvic girdle and neck ring, connected by a metal bar in both the front and back of the brace.

These metal bars play an important role, helping the torso extend while the neck ring keeps the head in a central position over the pelvis. Pressure pads are strategically attached to the metal bars with straps in accordance with the shape of the patient's spinal curvature.

The Milwuakee brace (first developed in 1945 by Dr Albert Schmidt and Dr Walter Blount of the Medical College of Wisconsin and Milwaukee's Children's Hospital) is viewed by many as the first modern brace designed for the treatment of scoliosis. It has undergone a number of tweaks over the years, although the current design has been in use since 1975.

The Milwaukee brace is far less common now that form-fitting plastic braces are available. However, it is still prescribed for some scoliosis patients with curves located very high in the spine.

Boston brace for scoliosis

Boston brace

The Boston brace was first developed in the early 1970s by Mr William Miller and Dr John Hall of The Boston Children's Hospital. It is a a type of thoracolumbosacral orthosis (TLSO), and it's one of the most commonly-used brace options when it comes to treating scoliosis.

TLSO braces are commonly referred to as 'underarm' or 'low-profile' braces. The Boston brace is much smaller and far less bulky than the Milwaukee brace, with plastic components custom-made to fit the patient's body exactly. The Boston brace covers most of the torso; at the front, it starts below the breast and extends all the way to the beginning of the pelvic area, while at the back, it starts below the shoulder blades all the way down to the tail bone of the spine.

This type of brace works by applying three-point pressure to the curve pattern in order to prevent further progression. This forces the lumbar areas to 'flex', pushing in the abdomen and flattening the posterior lumbar curve.

ScolioGold therapy and other treatments

If you've been diagnosed with scoliosis (or another curvature of the spine) and wear a back brace to help halt the progression of your curve, it is a good idea to undergo specialised physiotherapy as well. The sole purpose of a back brace is to stop the curve in your spine worsening during periods of growth; it does very little to assist in the building of the muscles needed for stability once the brace has been removed. To learn more about the specialised treatment courses for brace wearers that we offer here at the Scoliosis SOS Clinic, please click here.

In some cases, the treatment courses that we deliver can eliminate the need to wear a brace altogether! Please use the links below to find out more and book your Scoliosis SOS consultation.

Our Treatment Methods >   Contact Scoliosis SOS >